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223 CONSTR ON LIEN Jacob North Printing Co., Inc.. Lincoln. NE 68524 <br />m Z n <br />I <br />M C/) <br />n 3 cn <br />x <br />O O N O 'q <br />N O —4 <br />J <br />CD <br />CD <br />1- x rn CD <br />m <br />�D w <br />r <br />D <br />o v <br />200203660 <br />0 <br />C2 <br />CONTRACTING OWNER OR SUCCESSOR IN <br />INTEREST: REAL ESTATE: <br />�� t <br />- <br />- - - - -- - - ...... - ----- ----- . <br />(Name) (Legal Description) .-_- z ........ ------------------------------------ /,/ f], . ._....�il - <br />� cLa <br />r <br />ar -z ".I -Y --------- st. 8... R. <br />CLAIMANT: CLAIMANT CONTRACTED WITH: <br />--------------------------------------------------------- ...... .................. ........... <br />_�9 J (Name) <br />rllGS ��i1/ar..._Sa./� <br />- <br />----------------------- ..... ..._...._-- .._.. -- - - -------- --- -- - ...................... - ----------------------------------------------- <br />(Address) 4I� /� (Address) <br />........._I.._. ... .. -° - - -- -- -- --- - - - _ .............. ..... -.. <br />(30....38" - 7y7>°...... - .....- - -... - -------------------------------------------------------- <br />(Phone) (Phone) <br />/ oy � 9/ <br />BY CLAIMANT: ._��` or--. <br />SERVICES OR MATERIALS ..../ � 2��.... f..L �C �Pt ��y�... Z13 --------------- <br />/FURNISHED /.£1 <br />, F---C..^ G. g-. f�.c d- an_ ------- cxcc.'� ......... 1..---- (- --- -- <br />__. ----------------------- - ---------------- -- -- ............ ..-----...__....__..--.-...----....---.....------------------------------------------...._ ...................................... <br />............ <br />_..----..------------------------------------------------------ ...... _-_-------------------------------------------------------------------------------------- ------- ..- ----------- - °- - - -- <br />I ( / [s/ <br />-57 5 ............. ✓..... <br />CONTRACT PRICE: . - . .---- AMOUNT UNPAID: $----..- �/..SO. <br />TIME LAST SERVICES OR MATERIALS FURNISHED: .. ....--- --- --- ✓1....��/- �- -� ----- - ----------------------------------- ----------- <br />State of ---- - --- ............ - <br />rrG'. - - <br />.......... t7N;f-NX\... County} Signature of Claimant <br />On this ... 4\ _-- ----.. day of ---_ �r. x .. ----------- . ... ----- -- ----_-_._---- _- -_ -_ -_ , V l�� before me a Notary Public in and for <br />said county, personally came - 9 ..Q.- j._. ............................ to me known to be the identical person or <br />persons who executed the f nd acknowledged the same to be his, her, or their voluntary act an <br />deed. 3t tNabr981m ERMNS <br />TfMY*7CmM: <br />Api613.2085 .... .._. .................................... <br />Notary Public. <br />� <br />My commission expires the ......1� ' --- -- -------- day of ..... ... -. ._..,l... ----------------------- ..� -L.1. <br />STATE OF .... _ ---------------------------- - ---------- -- ------------ - - -... Entered on numerical index and filed for record <br />es. <br />County of ......---.-.-.--- .............._.. ...----- ------------------ ----. in the Register of Deeds Office of said County the <br />... .... - .day of------ --- --- ------------ ------ -- - ---- ----- ---- - -I at -------------------------------------- o'clock and ............. ---------- minutes ... ........... ..M. <br />and recorded in Book ----------------------------- of------ -- ---------------- - -..at page............................... <br />.--- -------- --- - ---------------- ....................... - ---------- Rev. of Desch <br />By------------------------------------- - --- -- --------------- - -Depu <br />